Lung Cancer Awareness
October 19, 2009
Dr. Ray Johnson and Dr. Himalaya Lele
Lung Cancer - Treatment Overview
Treatment for lung cancer depends on the stage of your cancer and may include surgery to remove the cancer, radiation therapy, or medications (chemotherapy). Treatment for non-small and small cell cancer may be different.
Treatment for lung cancer may include one or more of the following therapies:
If you smoke and have lung cancer, quitting smoking will make your treatment more effective and may help you live longer. Smoking delays healing after surgery, so you may have a better recovery from lung cancer surgery if you have quit smoking. People with early-stage lung cancer who continue to smoke during radiation therapy have been shown to have shorter survival times that those who do not smoke.12 It may also make chemotherapy less effective; the nicotine in tobacco seems to help the cancer cells and their blood supply multiply while also protecting the cancer cells from destruction.13 For information and help quitting smoking, see the topic Quitting Tobacco Use.
The kind of treatment and the long-term outcome of lung cancer depends on the type and stage of the cancer. Your age, overall health, and quality of life must also be considered. Many people with lung cancer are diagnosed with the disease when the cancer is already in an advanced stage. Only about 16% of lung cancers are diagnosed in the early stages when lung cancer is likely to be cured by surgery.1
Non-small cell lung cancer grows and spreads more slowly. Lung surgery (thoracotomy) is usually the standard treatment for non-small cell stage I to stage IIIA cancers. Treatment for non-small cell lung cancer also includes:
Small cell lung cancer grows very rapidly in most people and is more likely to spread (metastasize) to other organs. Treatment for small cell lung cancer includes:
Radiation therapy is combined with chemotherapy to treat small cell cancer that is limited to the chest.
Home treatment measures may help relieve some common side effects of your cancer treatment. For more information, see the Home Treatment section.
If you have been recently diagnosed with lung cancer, you may feel denial, anger, and grief. There is no "normal" or "right" way to react to a diagnosis of cancer; it varies from person to person. You can take steps, though, to manage your emotional reactions to learning that you have lung cancer. You may find that talking with family and friends is comforting, or you may need to spend time alone to understand your feelings about your disease.
If your emotions interfere with your ability to make decisions about your health and to move forward with your life, it is important to talk with your health professional. Your cancer treatment center may offer counseling services. You may also contact your local chapter of the American Cancer Society to help you find a support group. Talking with other people who have had similar feelings after a diagnosis such as yours can help you accept and deal with your disease.
What to think about during initial treatment
Your quality of life is critical when considering your treatment choices. Discuss your personal preferences with your oncologist when he or she recommends treatment.
Treatment for advanced-stage lung cancer is intended to control your symptoms and increase your comfort (palliative care), but it will not cure your cancer.
You may be interested in participating in research studies called clinical trials. Clinical trials are designed to find better ways to treat cancer patients and are based on the most up-to-date information. People who do not want standard treatments or are not cured by standard treatments may want to participate in clinical trials. These are ongoing in most parts of the United States and in some other countries around the world for all stages of lung cancer.
There are many clinical trials being done to see if combining chemotherapy or radiation treatments either before or after surgery is more effective for the different stages of lung cancer. Other clinical trials are studying different medication combinations for different stages of lung cancer. Discuss what choices are available for your lung cancer with your oncologist. For more information about specific lung cancer treatments, see the topics:
After initial treatment for lung cancer, it is important to receive follow-up care.
Radiation therapy may be used to prevent small cell lung cancer from growing in the brain. This is called prophylactic cranial irradiation (PCI). PCI may be most beneficial if you have limited small cell lung cancer and have had successful treatment with chemotherapy and radiation therapy to the chest.
Your emotional reactions are likely to vary during your treatment depending on how you feel, your prognosis, the treatment methods used, and your decisions about treatment.
Treatment if the condition gets worse
The long-term outcome (prognosis) for lung cancer that does not respond to treatment as hoped or that comes back after being treated is poor, and treatment focuses on managing your pain and improving your quality of life (palliative care).
Treatment to help control your symptoms (such as pain, coughing up blood, shortness of breath, and weakness) may include:
Other treatments being studied for lung cancer include radiofrequency ablation, microwave ablation, and cryoablation. Each of these is a way of trying to destroy the cancer cells without major surgery. These treatments may be useful for people who are not able to have surgery either because they are in poor health or because their cancer is too advanced.14
Additional treatment measures
In addition to conventional medical treatment, you may wish to try complementary therapies to help you manage pain and improve your quality of life.
Before you try any of these therapies, discuss their possible benefits and side effects with your health professional. Let him or her know if you are already using any such therapies. For more information, see the topic Complementary Medicine.
What To Think About
If surgery is part of your treatment, you also may be given radiation therapy or chemotherapy before surgery or after surgery to try to kill any cancer cells that may remain. Radiation or chemotherapy may be given before or after surgery when only microscopic areas of cancer may still be present. In some studies, people who receive radiation or chemotherapy after they had surgery to remove non-small cell lung cancer have been found to live longer, but other studies have shown little or no increase.15, 16
Most treatments for lung cancer cause some side effects. Which side effects you experience depends on the type of treatment used and your age and overall health. Your health professional can talk to you about your treatment choices and the side effects related to each treatment.
If standard treatments are not effective or are causing more side effects than desired, you may want to consider being part of a clinical trial. These trials study new or different ways to treat cancer.
As your cancer gets worse, you may want to think about palliative care. Palliative care is a kind of care for people who have illnesses that do not go away and often get worse over time. It is different than care to cure your illness, called curative treatment. Palliative care focuses on improving your quality of life-not just in your body, but also in your mind and spirit. Some people combine palliative care with curative care.
Some treatments for advanced-stage lung cancer are considered palliative care. These treatments cannot cure your cancer, but they can control your symptoms, reduce your pain, and make you feel more comfortable. They include:
In addition to helping your body feel better, palliative care can help you feel better emotionally and spiritually. Talking with a palliative care provider may help you cope with your feelings about living with a long-term illness. It may also help your loved ones better understand your illness and how to support you. Or it could help you make future plans around your health and medical care.
If you are interested in palliative care, talk to your doctor. He or she may be able to manage your care or refer you to a doctor who specializes in this type of care.
For more information, see the topic Palliative Care.
If you have advanced-stage cancer, you may choose not to have treatment because the time, costs, and side effects of treatment may be greater than the benefits. Making the decision about when to stop medical treatment aimed at prolonging life and shift the focus to end-of-life care can be difficult.
Notes via WebMD.com